Latest / Fork U with Dr. Terry Simpson / Cholesterol and Heart Disease

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Cholesterol and Heart Disease · Fork U with Dr. Terry Simpson

• 0:04
  >> Dr. Terry Simpson: In the topic about heart disease, you're going to
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  hear a lot about cholesterol. And it
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  gets confusing, because you're going to hear about good cholesterol,
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  bad cholesterol, LDL, hidl,
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  apob, small size, large
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  size, what does it all mean?
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  You're going to hear people state that LDL isn't important, but
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  that the size of particle or the oxidation is important.
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  And while all of this gets obscure,
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  today we're going to make sense of the madness
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  and show you how size isn't
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  important.
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  I am, your chief medical explanationist, doctor Terry Simpson,
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  and this is fork U forked
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  university, where we make sense of the madness. Busting
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  a few myths and teach you a little bit about food
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  is not always medicine.
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  Maybe you heard about LDL being the bad
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  cholesterol and HDl being the good cholesterol. And we
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  have to check your HDl triglyceride level
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  on and on and on. It really gets
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  confusing. Stripping away the good and bad
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  labels, we know that cholesterol, first of all, doesn't just
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  float around in your blood. Cholesterol is oil based
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  or waxy. And since your blood is water
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  based, we have to carry the cholesterol in
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  something. And so the cholesterol is placed in these
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  little packages of protein, and
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  those proteins are classified by their weight in a
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  centrifuge. And over time, we found that these
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  low density lipoproteins, that those
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  packages are responsible for
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  leaving deposits in the walls of your
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  arteries. And those deposits are called
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  atherosclerosis. And if you get a bunch of them together,
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  it's called a plaque. And those
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  plaques, when they rupture, lead to a heart attack
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  or to a stroke, or if they impinge on the
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  artery, meaning they start decreasing the flow of the
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  artery to the heart, they lead to heart ischemia
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  or angina. So
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  LDL isn't a one size fits all villain.
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  All the LDL particles vary in size, density,
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  oxidation, et cetera. So we're going to sort
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  of strip away one of the more common myths that I
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  heard, that you have to worry about
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  LDL, particle size. As if you couldn't hear
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  enough. We're going to strip that away because you don't
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  need to care about the size anymore. Size of the
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  LDL particle isn't important. And you don't have to
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  remember these old terms, like pattern a, large fluffy
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  particles are good. Pattern B, small dense
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  particles, are bad. Because the recent
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  research has shifted focus from the LDL particle
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  size to one of the lipoproteins
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  that surrounds the cholesterol, called apolipoprotein B,
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  which we will call ApoB.
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  Think of it this way. If you want to
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  not have messy tea, you
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  put your loose tea in something
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  like a teabag. Think about the
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  teabag as being partially held
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  together by one of these apob molecules,
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  right? So every single teabag, or
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  LDL particle carries one of
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  these little proteins, that Apop protein. Think of the tea
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  as the cholesterol. But that protein is a
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  passport that allows that
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  teabag to enter into the cell
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  wall of the artery,
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  not just passively, but it's actively
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  transported in. If there's an LDL particle, it's actively
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  transported into this cell wall.
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  And if there are too many LDL, particles in
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  that cell to be metabolized by that
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  cell, it tosses the LDL particles
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  out the backside of the cell into the wall of the
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  artery between the first and second layer.
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  That's where they build up, that's where they oxidize,
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  and that's where they can ultimately get so large
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  that they impinge on the artery wall, leading
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  to less blood flow to, like, the heart
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  artery, or less blood flow to the brain,
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  which can cause ischemia, a heart attack, or stroke.
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  The key is how many apob
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  particles there are. Now, we used
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  to think that that was the answer. The size
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  of the particle. We used to think small particles.
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  Wow. They're the bad ones, because when we looked at the research,
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  we saw small particles had more atherosclerosis. Is this
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  confusing you? But think about this. The more small
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  particles you have, you're gonna have more
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  apob, because if you bake a lot of little tea
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  bags, you gotta sew it together with that apolipoprotein
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  b, and that's a problem.
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  The particle number gives us a count of
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  how many of these atherogenic particles there are.
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  We call them atherogenic because the ApOB
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  particle is the thing, the particle that
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  leads to atherosclerosis. Doesn't matter
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  how large, how much tea is in the
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  teabag, how much cholesterol
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  is in the LDL particle. What matters
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  is how many of them are circulating in your blood.
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  Now, I've, heard people say, well,
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  cholesterol's important. It is. Cholesterol's
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  used in every cell. It is. Cholesterol's used to
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  make steroid hormones, like testosterone, estrogen.
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  It is. Cholesterol's important to your brain. It
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  is. But too much cholesterol, like too much
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  water or too much salt, or too much blood
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  sugar, is bad. Too much
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  cholesterol leads to atherosclerosis.
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  Some people say God doesn't make mistakes. Well, I don't know if God
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  made a mistake or not. We're not going to live forever. But if
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  you want to live longer, you want to have less
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  atherosclerosis. There have been
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  a number of articles that have shown this, that it is
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  the number of apob particles,
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  nothing, not the size of
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  the molecule. And there's two ways of looking at this.
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  If you have a bunch of little tiny molecules of ldl, which
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  have small particles, and they get in and they're tossed out
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  to the back, well, it's going to take a lot of those
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  to build one large cholesterol particle which is
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  equally actively transported in. So
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  you have a lot of large, fluffy particles, you'll have a
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  faster buildup. Now, what are things that increase
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  apob in your body? One of them
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  is sugar. That's why
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  diabetics need to be under better control, because
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  more glucose in your blood, the more spikes you have, the more
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  insulin resistance you have, the more diabetes you have, you're making
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  more APOB particles. The more apob particles, the more
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  atherosclerosis, the higher your risk of heart disease.
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  That's all. That's as simple as that.
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  So here's the key. This month,
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  when you go to your doctor, APOB is the
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  test you want to ask for. They'll give you a standard
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  cholesterol panel. It'll have your hdl, your
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  ldl, your total cholesterol, your
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  triglycerides. Ask to get an
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  APOb test. And while you're at it, also ask to get a
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  PSA test, because this month, this month,
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  we want you to do cancer screening. So, American
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  Cancer Society, what's my number? Screen me,
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  etcetera. So there's been lots of
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  meta analysis of participants showing how APOB is a stronger
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  predictor of heart events than cart particle
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  size. And I won't bore you with it, but if you want to find out more of
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  the detail and more of those for the nerdy bunches of
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  you, and most of you are nerds, go to the blog associated with
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  this@yourdoctorsorders.com or four
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  q.com.
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  now, how can diet and lifestyle affect the
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  apob number? We already talked about refined grains,
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  but saturated fat like red
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  meat increases apob
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  particles. Lean meat,
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  plant based fats like olive oil and
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  avocado don't. They might actually
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  decrease APOb number. So changing your diet from
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  saturated fats to less saturated fats when you get
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  below 9%, we see that change.
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  I know the low carb people never like this because
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  they want to wave off cholesterol, because every
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  article out there shows that low carb and keto diets lead to
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  higher ldl numbers,
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  increasing the fiber in your diet. Soluble fiber, like
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  foods found in oats, beans, and fruits,
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  reduce the number of ldl and apob particles in your
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  bloodstream. How do they do that? Because here's
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  what happens when your liver
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  makes ldl. Because this cholesterol is made and you're packaged
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  in your liver, what happens is it doesn't
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  just throw it into your bloodstream. It makes
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  all these ldl particles and puts it into your bile.
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  Your bile is secreted by your liver and goes into your
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  intestine, and from your intestine, it goes into your
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  bloodstream. Now, when you eat more
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  fiber, the fiber binds
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  to those LDL particles, and those fibers
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  that bind to the LDL particles
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  passively go out of your backside
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  into the toilet. Right.
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  Diets that are high in processed carbs and sugar raise apob
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  levels. And so those diets also have less
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  fiber. So increasing the fiber in your diet not only makes
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  you feel full longer, it decreases your
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  apob particles. I'll give you another
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  example. Whole grains, brown
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  rice, quinoa,
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  oats, corn,
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  all have fiber that
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  decrease apob. Refined grains don't have
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  fiber. Lead to sugar spikes lead to more
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  manufacturing of apob. That's why refined
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  grains aren't good. That's why whole grains are.
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  Okay? Okay, so to wrap
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  this up, while we used to think the size of the
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  LDL particle was important, it really is apob.
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  Ask your doctor for an apob. That's how we
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  get a better picture of your heart. What should your levels be? In the
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  United States, we want your apob levels to be under 100.
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  In Europe, we want them under 70. We'll probably go to under
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  70. Why do we keep changing this every
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  year? Because we have discovered over time that the lower
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  your total cholesterol number is, the healthier
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  you are. Now, there are m those people who say, well, you know,
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  long live people have higher ldls.
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  Okay? If you get to be old, you can have a
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  higher ldl. But remember, there are many other things that
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  influence this. Meaning this. I'll
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  give you one example. There's a genetic
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  predisposition to people called the PCSK nine
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  transport system. And if you have a genetic
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  defect in that, you can have high ldl,
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  but you also have high ldl
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  receptors. Because you have high ldl receptors, you
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  don't have that much ldl in your body. It's cleared very
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  quickly. And those people live
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  long. Remember, longer lived people,
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  still die of heart disease, still die of cancer, still
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  have diabetes, still have cognitive decline. They
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  just put it off for a while.
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  So get your ldl down. Is there a
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  lower level? Well, we know below. I think it's 53. You're probably
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  not going to have heart disease. What do kids
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  need? What do you need to maintain the amount of
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  testosterone and keep your brain well? Remember your lDl.
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  Your brain makes its own cholesterol. It doesn't rely on your
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  liver. Your gonads
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  make your own testosterone and estrogen. They don't rely on your
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  liver. So don't listen to people who say, that's
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  all I terribly important because too much cholesterol, like
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  too much salt, like too much blood sugar is
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  deadly.
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  All right, go to my blog, yourdoctorsorders.com, or
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  fork u.com, to see all
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  of the references and you can look them up for yourself. This
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  episode was written and researched by me, doctor Terry Simpson.
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  And while I am a doctor, I'm not your doctor. Please
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  see your doctor, a western trained, non
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  chiropractic, non eastern trained
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  physician. And if you're curious about, what
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  your LDl APOB number is, please see your regular doctor for
• 11:43
  that. Podcast is distributed by our friends
• 11:45
  at Simpler Media than the pod God, Mister Evo
• 11:48
  Terra. Our production is done by producer Girl Productions, who
• 11:51
  insist on my hair being perfect even though we're not
• 11:54
  doing video today.
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  Until next time, stay curious. And
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  remember, food can be a powerful influence on your
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  health.
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  This month is cancer screening month for
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  prostate cancer. See, we want you to know your PSA
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  number, just like I know my APOb number, which is 63.
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  My PSA number is three. We want it under four.
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  So I hope this month you go to the American
• 12:24
  Cancer Society, get screened, find out your
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  psa number. Because after all, min 50
• 12:30
  and over, we need to know the number. And I hope
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  yours is less than four. And be sure and check
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  out your apopee number. Also.
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  >> Speaker B: 2.97, I'm happy to report. And
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  yes, that is checked on a regular and frequent basis with
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  me. And thanks for the information on the
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  APOB. I'm never going to drink tea in a
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  teabag again.